The Affordable Care Act Helps The Middle Class

Like Steve Benen, I think it’s great that French President Nicolas Sarkozy is a fan of the Affordable Care Act. But Sarkozy — and Americans — should understand better what the ACA is about:

“Welcome to the club of states who don’t turn their back on the sick and the poor,” Sarkozy said, referring to the U.S. health care overhaul signed by President Barack Obama last week.

From the European perspective, he said, “when we look at the American debate on reforming health care, it’s difficult to believe.”

“The very fact that there should have been such a violent debate simply on the fact that the poorest of Americans should not be left out in the streets without a cent to look after them … is something astonishing to us.”

Thanks for the compliment, Nick, but get a better briefer.

The ACA really is not about the “poorest of the poor.” That population is helped predominantly by Medicaid. To be sure, there are lots of gaps in Medicaid — and there will be more until and unless Congress funds it better. Single low-income people do not get it in most states. But it is the program for the destitute.

The ACA, on the other hand, is basically about the real middle class in this country — people making 150% of the poverty level, up to about 350%. In other words, it insures families of four making between roughly $33,000 and $77,000 a year. Individuals on the exchange, or in the interim high-risk pool, are working people, small business owners, prospective small business owners, etc.

I don’t begrudge Sarkozy for making this mistake; he’s got enough on his hands, after all. But Democrats must avoid it. Otherwise, the Right will smear this thing as yet another handout to “those people” (and we know what color they are and/or what countries they come from) who are lazy and shiftless, etc.

We should be helping the “poorest of the poor” to a much greater degree than we do. But let’s not confuse the way that the biggest piece of social legislation since the Great Society actually works.